The House Energy & Commerce oversight subcommittee will hold a hearing Thursday (Sept. 6) to review abuse, neglect and substandard care in nursing homes, and federal efforts to make sure residents are safe.

The House Energy & Commerce health subcommittee will hold a hearing Wednesday (Sept. 5) to discuss the Advancing Care for Exceptional Kids Act, an extension of the Medicaid Money Follows the Person Demonstration, a bill to clarify the authority of the Medicaid Fraud and Abuse Control Units and legislation to codify the Healthcare Fraud Prevention Partnership.

The House Energy & Commerce health subcommittee will hold a hearing Sept. 5 on draft legislation banning so-called gag clauses in Medicare and the private market that prevent a pharmacist from telling a patient when it would be cheaper to buy a drug with cash rather than insurance.

Patient groups and doctors -- some of whom just signed on to the American Medical Association's push to get CMS to back away from proposed cuts to evaluation and management pay -- are asking CMS to discuss with stakeholders alternative ways to reduce paperwork that don't include its proposal to simplifying E/M coding.

CMS is negotiating with inpatient rehabilitation facilities to potentially settle Medicare appeals, HHS says in a recent court briefing, and additional settlement meetings with the IRF lobby are expected in the upcoming months.

HHS projects that recent settlements and increased funding from Congress should allow the department to eliminate the Medicare appeals backlog in fiscal 2022 -- assuming the higher funding level for the Office of Medicare Hearings and Appeals continues -- so the district court shouldn't require anything but status reports from the department.

More than 150 medical organizations, led by the American Medical Association, told CMS Administrator Seema Verma Monday (Aug. 27) that they oppose CMS’ proposal to simplify evaluation and management coding.

Congress should not use a measure that extends the time kidney-failure patients can stay on private insurance to help pay for House opioid legislation, insurers, unions and employers told Senate leaders, but patient groups praised the House legislation.

The HHS Office of Inspector General is asking for feedback on how to coordinate the anti-kickback and physician self-referral, or Stark, laws as well as how to set up safe harbors to help alternative pay models and the possibility of letting providers waive co-pays or provide other incentives to beneficiaries as a way to promote care engagement.

The Senate-passed “minibus” spending bill asks the Office of the National Coordinator for Health IT to update Congress on 21st Century Cures Act regulatory action relating to information blocking and the conditions of certification for health IT.

CMS will tweak a demonstration in order to continue allowing providers affected by state-wide moratoria on home health agencies and non-emergency ambulances to participate in Medicare, Medicaid and CHIP if there are proven access to care concerns, and the agency also will allow those that had a pending application denied when state-wide moratoria kicked in to participate in the programs through the demo.

As CMS weighs national coverage policy for an expensive new CAR-T cancer treatments, Sloan Kettering's Peter Bach argues the agency has the ability to limit coverage until more data is collected on the therapy.

The House Ways & Means Committee plans to send four letters to CMS highlighting ways to relieve administrative burden for hospitals, post-acute care providers, physicians and rural providers as part of its Medicare red tape relief project, but a new report from the committee includes no concrete plans for legislation despite Chair Peter Roskam's (R-IL) call earlier this year for legislative action this summer.